When both kidneys go into failure we are left with two treatments
i) Dialysis or,
ii) A new kidney from some donor who is living or dead.
The dialysis is a temporary solution till we get someone who can donate the kidney which is matching our body. The dialysis is painful and time-consuming.
We have to go on dialysis every week 3 to 4 times and takes almost 5 to 6 hours per seating. So all are left with the option for Renal Transplant as a permanent solution.
But unfortunately we have a lot of patients awaiting this procedure and we don’t have many donors. Also, there are restrictions legally who can donate a kidney and also we need to match kidney before transferring to someone.
There are two types of kidney transplants. First is when we get it from a person who is living and having two functional kidneys. He donates one and sustains rest of his life on one kidney.
In India legally donor should be related to the patient from his family and moreover everyone from family cannot give the kidney to others.
We need to do kidney matching called HLA typing to see whether kidney from this person can be transferred to other or not.
The second type is when we get a kidney from the donor who has written will to donate after his death or some brain dead patient after consent from his family.
Once we get kidney donor, we need to undergo a surgical procedure. First, there will be induction phase in which the patient will be optimized for surgery to increase chances of kidney survival.
He will undergo immunity suppression as every human body will not accept any other body part in own body due to own immunity.
After immunity suppressed with medication and blood testing carried out, the patient will be fit to undergo surgery.
In this phase, we have to optimize other illness which patients might be having such as high blood pressure, abnormal sugar profile, cholesterol, thyroid or any other systemic diseases.
Once the patient is fit for surgery, tow operations will be carried out simultaneously. One on donor and other on the recipient.
The kidney is harvested from a donor and same time implanted in the patient either same place where the old damaged kidneys were present or in the groin depending upon the decision of doctors trained in this procedure.
Once the operation is over, the patient will be shifted to specialized Renal Transplant Wards and will be monitored closely to ensure newly transplanted kidney start functioning in the patient.
The patient will require strict monitoring of diet and may require dialysis till kidney takes over the function completely.
We need highly specialized staff to avoid any chance of infection as the patient is already taking medication to suppress own immunity.
After the hard work of specialized doctors and trained staff, the patient will get freedom from weekly painful, time-consuming dialysis.
Once kidney starts functioning, the patient can now live a normal life and need to monitor kidney function regularly.
Few patients may land up with complications and failure. The new kidney fails to work in some patients.
So it is always recommended to get operated by specialized, experienced doctors and specialized centres with adequate facilities to carry out sophisticated procedure and well equipped with trained medical staff.
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